Sperm analysis done. Taking Trazure M. Looking for suggestion

Last two manths back, I got my sperm analysis done in which the sperm count came as 16.8 m. On which my doc suggested a tab daily in evening i.e Trazure M , which will help to increase the count.

Unfortunately after two months, I did the check again and now the count has dropped to 8m.

As per my doc, this can be due to various reasons. Below are my questions
1. Is the variation in count so high, that it can become half in two months
2. Gap kept before check was told to me for 4-5 days, but in 2nd check the gap was for 6-7 days, can this also impact.
3. Now my doc has asked me to stop this Trazure M and to start with Oligocare.

Answer to your query 1Causes of low sperm count are many. Your doctor must have ruled out the diseases causing low sperm count eg. varicocele, hydrocele, hormonal disbalance, tumors and infections like prastatitis.Other factors affecting sperm count are age, strenuous riding or strenous exercise, medications including androgens, addictions like smoking and alcoholism.So if these factors were present in you before testing, they can lead to reduction in sperm count to any extent.Apart from the semen quality itself, there are various methodological factors that may influence the results.Compared to samples obtained from masturbation, semen samples from collection condoms have higher total sperm counts, sperm motility, and percentage of sperm with normal morphology. For this reason, they are believed to give more accurate results when used for semen analysis.If the results from first sample are subfertile(low counts), they must be verified with at least two more analyses. At least 2 to 4 weeks must be allowed between each analysis. This is because there is a large amount of natural variation over time, meaning a single sample may not be representative of a man's average semen characteristics.In addition, the stress of producing an ejaculate sample for examination, often in an unfamiliar setting of hospital may lead to changes in count than a sample produced at home. But after collecting, It has to be kept at body temperature and must be examined within 1-2 hours after ejaculation as these would also affect results.Variation in count of your recent report can be affected by all these if they were present at the time of testing.

Answer to query 2You will need to refrain from ejaculating for at least 3 days before getting a test.With increasing durations of abstinence from ejaculation before the tests there has been improved results and so you were advised a gap of 6-7 days this time.For every additional day up to about 7 days, the sperm concentration can increase about 25%. This makes comparison of results very difficult if different abstinence intervals are used. So for comparison of results , same abstinence interval has to be used. Natural biological variation can also affect your results. Just as no one wakes up the exact same every day, semen analysis parameters will vary from day to day also. It is perfectly normal for there to be variation in these parameters from sample to sample within the same individual even if there has been absolutely no change in that persons intrinsic fertility potential.Last possibility can be laboratory error.So repeated testing to confirm is a must.

Answer to query 3Oligocare provides a unique combination of essential micronutrients and vitamins, to help support male fertility along with lycopene and L-carnitine. It prevents spermatozoa from oxidative damage,improves sperm maturation, improves sperm motility and quality and enhances chances of pregnancy.Trazure M is also used for the same purpose but since your response in terms of report was not good, the doctor must have changed the preparation.

Other measures you can take to improve your sperm count are:The more times you ejaculate, the less dense your semen will be. Refrain from habits like smoking, alcohol consumption. Alcohol affects your liver function, which, in turn, causes a dramatic rise in estrogen levels. Even two drinks a day will have long-term effects on sperm productionEat Nutritious Food low in fat, and high in protein, vegetables, and whole grains is good for your health and for your sperm. Avoid bitter, astringent and spicy foods.Reduce caffeine intakeAvoid heating of testicles by wearing loose, cotton boxer shorts.Avoid hot baths and saunas.Lose any excess weight, which tends to cause hormonal imbalances.Reduce stress levels by learning relaxation techniques.Keep your mind and body healthy by regular practice of yoga and meditation. Sperm levels are often highest in the mornings so chances of pregnancy increase if you have contact during this time.

Thanks Dr. Asra for this detailed revert. Yesterday, I had a chat with one of your colleagues online and the response was somewhat the same, but your was on more details which I will like to appreciate and thank you for that. He also suggested to share the reports with online urologist for 2nd opinion which I have uploaded today morning.

Just to update you that, I do not smoke, nor drink any alcoholic product. My Wt. is 75 kg. Have Light coffee only once a day at office. At home we do not have food with much of oil.

Yesterday my doctor advised not to start with Oligocare, keep a gap of 5 days, and get the semen analysis done once again. She also added Coq10, but not to start now. Post test, she will suggest how to go ahead.

1. You said something about collection of semen collection condom. Are these available at Hospitals, as you rightly mentioned it becomes difficult to ejaculate thru masturbation into a sterile box at hospital toilets.

2. Are there possibilities that today my count is suppose 100 for example and next week it can become 20%. Is the variation so high.

3. My age is 34, does this age also have an impact on count.

To which hospital you are attached and is it possible to XXXXXXX you or have a talk on phone.

Answered by Dr. Asra Ishtiaq Ahmed 6 hours later

answer Id 106237; conversation id 104487

Hello there.

Thanks for writing back.

Answering your queries one by one :

1. Semen sample can be collected during intercourse in a special type of condom known as a collection condom. Collection condoms are made from silicone or polyurethane. Commonly used condoms are made of latex which is somewhat harmful to sperms. Besides the condom you are using should not contain spermicides or lubricants. Good infertility/IUI centers should have these special collection condoms (SCD).

2.There is marked variation in sperm counts from sample to sample and month to month. What is important is what range the counts are in rather than what the absolute number is. If a normal sperm count is above 20 million/ml and one month it is 25 million/ml and the next 35 million/ml, there is no real difference in the effect on fertility. As both these reports are above the normal count and would be taken normal. Similarly if the count is reduced at 1 million/ml and two months later it is 5 million/ml, likewise, there is unlikely to be an effect. Random variation is the norm and small changes over time should not be seen as being progression or regression. If repeated tests show your counts to be above the normal accepted (20 million/ml), you have a normal sperm range.Sperm count is only an indication of fertilizing capacity and a normal count does not guarantee success. In addition, more is not necessarily better, as too high a sperm count can also result in fertility problems.

3. Sperm count does decrease with age. The decrease in sperm count that comes with old age is much more of a gradual thing. But the decrease in sperm count can vary among individuals. But the impact of age is usually seen after 40 years.There is also a decrease in the quality and motility of sperms with age. For example, genetic defects are much more common in old age.

I hope I have answered your query. Kindly revert back in case you have any further doubts.